Below are contact details for various surgeons who perform weight loss surgery in New Zealand. All information was correct at the time of publishing, but is subject to change. It's really important to do your research on the surgeons as well as the procedures, as not all surgeons were created equally. Don't be afraid to ask them for their individual mortality rate, if they have nothing to hide they will not hesitate in sharing this information.
You can also check out the forums and chat with people who have first hand experience with these surgeons.
Marinoto Clinic, 72 Newington Ave,Maori Hill, Dunedin
Phone: (03) 467 2425
Laparoscopic gastric banding
Procedures
This is a home entry re procedures.
Roux-en-Y Gastric Bypass
Basic Overview
The Roux-en-Y gastric bypass has been around in one form or other for over 30 years and is now performed both open and laparoscopically.
The stomach is divided completely with a stapler, the upper part of the stomach becoming a 10 – 30ml pouch which will increase in size over time. The small intestine is divided, and the lower part of it is brought up and joined to the pouch, effectively creating the “food channel” which will bypass the lower part of the stomach, and the upper part of the small intestine.
The upper part of the small intestine is joined back to the lower end further down from the stomach, and gastric juices, digestive enzymes and bile continue to flow through this “alimentary channel”. The junction where these two channels meet creates a “Y” shape, giving the Roux-en-Y gastric bypass it’s name.
The Roux-en-Y works in two ways:
because the pouch is small you feel fuller faster; and
eating foods high in fat or sugar can lead to “dumping syndrome” (feeling sweaty, nauseous or dizzy), discouraging bad eating habits.
Advantages
Faster weight loss than gastric banding.
Dumping syndrome deters patients from eating foods high in fat or sugar.
Long track record.
Generally more effective for keeping weight off long term than gastric banding.
No mechanical parts.
Disadvantages
Slightly higher risk/complication rate.
Slightly longer recovery time than gastric banding.
Gastric banding is a minimally invasive technique which is completely adjustable and therefore reversible.
A silicone band which is hollow and inflatable is fastened around the upper stomach creating a small pouch. The band is then inflated with a saline solution, causing it to tighten. A small port is placed under the skin so that after surgery the band can be tightened or loosened as needed by injecting or removing saline solution through the port.
Advantages
The least invasive procedure.
Lower mortality risk.
No cutting, stapling or re-routing.
Faster recovery time.
Lower risk of hair loss.
No dumping syndrome.
No malabsorbtion.
Adjustable and reversible.
Disadvantages
No deterrent from eating foods high in fat or sugar.
Frequent follow-ups are required for band adjustments.
A foreign object which can be subject to mechanical failure or slippage.
The sleeve gastrectomy has traditionally been performed as a first step on patients who are not able to undergo other procedures, generally because they are extremely obese. However it is now becoming a popular first and only step.
The outer portion of the stomach is removed, reducing the size of the stomach to around 10% - 25% of what it was and creating a long, thin tube. The smaller stomach creates an earlier sense of fullness.
Advantages:
No joins to leak.
Less malabsorbtion than gastric bypass.
No mechanical parts.
Simpler to perform than a gastric bypass.
No re-routing.
Disadvantages:
Relatively new procedure, so no long term data available.
May require further surgery depending on results.
Generally takes longer to cure diabetes than a gastric bypass.
The Fobi Pouch gastric bypass has the same type of pouch construction as the Roux-en-Y gastric bypass. However rather than staples, it uses a silastic ring around distal end of the pouch to simulate the pyloric valve and prevent stretching of the opening between the pouch and the section of small bowel. A gastroenterostomy to a Roux-en-y type limb of the jejunum completes the procedure.
Advantages
Research indicates the Fobi Pouch is more effective than the Roux-en-Y.